To enable them to reach a decision, they based their scenario on an aircraft in flight declaring an emergency and which required a high level of resources being deployed to the airport in advance of the declared aircraft emergency. Given that the aircraft was at the mercy of gravity and had the potential for mass catastrophic injuries, the decision was that the emergency services could be mobilised to the airport under emergency road conditions, to ensure they reached there before the aircraft crash landed.
This makes rational sense; however the vast majority of patients attended to by ambulances are at home, at work, in public places or in motor vehicles and not suspended in the air at risk of catastrophic injuries if gravity fails to support them. The Department of Health was contacted further and the obvious differences pointed out. The Senior Policy Advisor for Urgent and Emergency Care at the Department of Health (James Vallance) considered all point we raised and responded accordingly.
The key principle that the Department of Health expect ambulance services to apply when dispatching resources is that:
Ambulance Services can dispatch a vehicle under blue light conditions whilst the 999 call is still in progress but only when the call taker has confirmed that it is a genuine emergency call for which an ambulance is being requested. It is the responsibility of individual ambulance services to ensure that they only dispatch a blue light response when they have determined it is a genuine emergency call.
These key principles are not being applied by the Trust because we are aware that resources are being dispatched under blue light conditions while the call taker is still establishing the address, post code and telephone number of the caller. The questioning process follows a set sequence and before it can be confirmed that an actual medical emergency exists, resources are being deployed.
The Trust has issued a directive that crews must respond to all emergency calls with blue lights switched on. The use of blue lights is a privilege afforded to emergency vehicles and the use of them places enormous responsibility on the driver of the vehicle. When responding to or from an emergency the driver should be constantly assessing and evaluating the road conditions; traffic density and volume; as well as fixed, moving and environmental hazards; remembering at all times that the presence of an emergency vehicle with blue lights on can be the catalyst for a road accident to happen, and the presence of the ambulance becoming the cause of the accident.
When driving to and from an emergency there are seven exemptions which the driver may elect to claim in respect of The Law. These are:
- Exceeding the speed limits (capped by + 10 mph in a 20 zone and +20mph elsewhere)
- Treating red traffic lights as a give way (not an invitation to drive through recklessly )
- Using audible warnings at night (road horns and sirens between 2330 and 0700 hours)
- Observing keep left / keep right signs
- Motorway regulations (to avoid/prevent an accident or to help at an accident or emergency)
- Entering a bus lane or bus street
- Entering a pedestrian precinct
There is no automatic right to claim exemptions and the driver must always be able to justify the need for the exemption being claimed. As professional drivers we must make safety our primary concern with regard to all our driving decisions. When driving to or from an emergency it should be at a speed which is suitable for the circumstances and one that you can stop the vehicle safely in. Use to speed wisely, remember that at 30 mph a driving error can be corrected but at 70mph the same error could be disastrous.
- Do not drive at speed unless you are competent and it is safe to do so.
- Be familiar with the controls and characteristics of your vehicle, using controls smoothly.
- High speed driving requires maximum alertness; if you cannot achieve this high level because of fatigue or some other cause, do not drive.
- Be aware of the onset of fatigue and take the appropriate action.
- Always drive so that you can stop within the distance that you see to be clear, by day or by night.
- If you double your speed, quadruple your stopping distance.
In conclusion, the decision to claim any of the listed seven exemptions is the responsibility of the driver and all exemptions which are claimed must be justified and carried out in a safe manner.
Branch Health & Safety Officer
East of England Ambulance Unison 20106
7th August 2014.